Healthcare Provider Details

I. General information

NPI: 1912098377
Provider Name (Legal Business Name): INTERIM HEALTHCARE OF THE TRIANGLE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 03/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6310 CHAPEL HILL RD SUITE 280
RALEIGH NC
27607-4242
US

IV. Provider business mailing address

6310 CHAPEL HILL RD SUITE 280
RALEIGH NC
27607-4242
US

V. Phone/Fax

Practice location:
  • Phone: 919-420-0336
  • Fax: 919-420-0172
Mailing address:
  • Phone: 919-420-0336
  • Fax: 919-420-0172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHC2074
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License NumberHC2074
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberHC2074
License Number StateNC

VIII. Authorized Official

Name: MRS. DONNA LOU BYRD
Title or Position: OWNER
Credential:
Phone: 919-420-0336